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Quantitative In Vivo Measurements of Tumor Perfusion Using Rubidium-81 and Positron Emission Tomography

Joint Department of Physics, Royal Marsden Hospital and Institute of Cancer Research, Sutton, United Kingdom
Perfusion Laboratory, Royal Marsden Hospital, London, United Kingdom
MRC Radiobiology Unit, Chilton and Department of Radiotherapy, Royal Marsden Hospital, Sutton, United Kingdom
MRC Cyclotron Unit, Hammersmith, London, United Kingdom

Correspondence: For reprints contact: Simon A. Cherry PhD, Department of Nuclear Medicine & Biophysics, Division of Radiological Sciences, UCLA School of Medicine, Los Angeles, CA 90024.

ABSTRACT

Rubidium-81 (t = 4.58 hr) was investigated as a tumor perfusion tracer in the VX2 carcinoma implanted into rabbit thigh muscle using a large-area, multiwire proportional chamber positron emission tomography (PET) system. Perfusion was determined using the arterial reference sample method, and the results from PET imaging were compared with postmortem tissue sampling. Absolute quantitation of tumor perfusion was achieved using external probes to estimate local extraction fraction. Redistribution of rubidium-81 (⁸¹Rb) was investigated using a dual-tracer technique. Average perfusion was found to be 13.5 and 3.7 ml/min/100g in tumor and normal muscle, respectively. The extraction fraction as estimated from a two-compartment model ranged from 0.94 to 1.00. No significant redistribution of ⁸¹Rb was observed in these tissues. Nine patients with malignancies were studied using ⁸¹Rb and PET. Tumor perfusion in four patients with carcinoma of the breast was elevated by a factor of 1.8 (range 1.2–2.3) compared to contralateral normal breast.